Picturing Depression: Faces, Backgrounds, and Foregrounds

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 3 - 22

Опубликована: Янв. 30, 2025

Abstract Depression takes diverse forms, each with distinctive epidemiology, phenomenology, and optimal treatments. In case of depression, culture is background; unique individual circumstances are foreground. Exemplary cases described. historical contemporary Japan, older people often devalued socially excluded; this can lead to “lonely deaths” from self-neglect or unnatural deaths including suicides. China’s long-standing tradition authoritarian parenting burdensome filial obligation underlies depression in younger adults. American regions have depression-relevant cultural differences as large those between nations. Utah, high gender inequality associated a prevalence young women. Connecticut income wealth entail problematic substance use among lower socioeconomic class. Cultural awareness, knowledge different communication styles, empower clinicians make more accurate diagnoses build therapeutic relationships.

Язык: Английский

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Опубликована: Янв. 30, 2025

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Cultural Identity and Personal Biography

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 88 - 98

Опубликована: Янв. 30, 2025

Abstract Cultural identity strongly influences the personal meaning of common life events like marriage or retirement and probability adverse childhood (ACEs) intimate partner violence (IPV). Some cultures normalize ACEs IPV. Life can require adaptation to a new environment, involving acculturative stress sometimes family distancing. These include not only immigration but also migration within countries, changes in socioeconomic class, onset major illness disability, composition, aging. Acculturation is most successful when people become bicultural, integrating old identities. Depression risk greatest feel isolated: disconnected from both their native culture that environment. Second-generation immigrants experience “acculturative distancing.” Effective psychotherapy depression often requires addressing acculturation-related issues recognition traumas stresses normalized by patient’s culture.

Язык: Английский

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Truck-Driving Blues

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 652 - 684

Опубликована: Янв. 30, 2025

Abstract Truck drivers have a high prevalence of depression. Their life expectancies are short, in part due to unhealthy lifestyles and associated chronic diseases. Depressed more likely be involved crashes. occupational risk factors for injury, general medical illness, depression include chronobiologic stress; continual exposure noise, vibration, polluted air; poor-quality food at truck stops; prolonged periods sitting; time pressures; loneliness when away from home; work–family conflicts; work schedules that interfere with consistent healthcare. Obesity sleep apnea prevalent challenging treat. Drivers’ culture contributes normalization illness pain, denial or externalization depression, internal stigma. Evaluation depressed driver should identify addressable job-related neglected problems. Enhancement function crash prevention non-stigmatizing foci clinical intervention compatible culture.

Язык: Английский

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Cultural Correlates and Clinical Consequences

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 140 - 160

Опубликована: Янв. 30, 2025

Abstract Cultural identity is associated with diet, activities, sleeping habits, and patterns of substance use. All directly relate to the risk expressions depression bipolar spectrum. Related structural factors include housing quality; environmental hazards; quality food, healthcare, public education; availability highly lethal means self-harm. It influences prevalence phenotypes: melancholic, anxious, primarily somatic, or externalized “masculine depression.” External stigma universal, but its details are culture-dependent. The acceptability feasibility specific treatments vary by culture. Before prescribing against a patient’s culturally based biases, clinician should consider not only medication psychotherapy also lifestyle changes; complementary, alternative, integrative medicine; antidepressant smartphone apps; light therapy; non-invasive brain stimulation. Depression biomarkers soon may have role in selection that both compatible likely work.

Язык: Английский

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Depression and Social Class: A Four-Dimensional View

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 113 - 139

Опубликована: Янв. 30, 2025

Abstract A simple correlation of income, social class, and depression risk is misleading. Education, occupation, wealth, heritage can be as important income in determining status. The practical meaning a nominal numerical varies by place residence. Relevant mediators are place’s cost living, distribution public policies related to housing, healthcare, support. Within racial groups the United States, median household wealth vary greatly national origin. Open expression depressive emotions more likely acceptable upper classes, somatic especially common lower classes. Non-irritable presentations hypomania sometimes normalized class. change class either direction entail loneliness loss capital that contributes depression. Effective treatment require adaptation class-related circumstances.

Язык: Английский

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Japan: Invisible Double-Edged Swords

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 293 - 341

Опубликована: Янв. 30, 2025

Abstract Traditional Japanese culture uniquely combines elements of Buddhism, Daoism, and Shintō. It is more collectivistic than Western individualistic Chinese culture. Aesthetics organizational are highly developed, with survival value external appeal but underlying negative or risky implications. Communication high-context, understated, often non-verbal paralinguistic. Self-construal interdependent. Shūdan ishiki (group consciousness) universal, ba no kuuki wo yomu (“reading the air”) an essential social skill. Melancholy normalized, suicide rationalized romanticized. Haji (shame) a common reaction to error failure, sometimes unbearable point suicide. Distinctive presentations depression self-harm arise from this cultural context, including kodokushi (lonely death), karōshi (death overwork), shin-gata utsubyo ("new type depression” “modern depression”). Depression can be obscured by normalization melancholy bipolarity culturally sanctioned overwork pleasure-seeking.

Язык: Английский

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China: Confucian Harmony and Dissonance

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 201 - 292

Опубликована: Янв. 30, 2025

Abstract Conflicts of China’s traditional Confucian culture with modern realities contribute to depression and suicide in Chinese immigrants Western countries, international students, rural including internal migrants their “left-behind” family members. Traditions include authoritarian parenting, extreme emphasis on academic success, obligations filial piety, rigid gender roles. Immigrants experience acculturative stress distancing. In culture, is heavily stigmatized, its overt expression discouraged. Negative emotions often are expressed metaphorically. Treatment can be complicated by fear medications reluctance self-disclose psychotherapy. Clinicians address this eliciting patients’ personal illness narratives, disclosing a diagnosis stages using language compatible models beliefs, negotiating personalized treatment plan.

Язык: Английский

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Depression and Suicide in the “World’s Happiest Countries”

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 380 - 429

Опубликована: Янв. 30, 2025

Abstract The Nordic nations—Denmark, Finland, Iceland, Norway, and Sweden—and Switzerland are consistently among the world’s 10 “happiest countries.” Their residents enjoy excellent education healthcare, relatively high upward mobility, a small gender gap, natural beauty. However, their positive social determinants of health do not prevent depression or suicide. Compared with Western Europe overall, Finland Sweden have higher prevalence major depressive disorder. Suicide rates for both genders in Sweden, Switzerland; men Iceland; women Denmark Norway. Cultural differences help explain epidemiology. has historical trauma, tradition stoicism, widespread binge drinking. highly prevalent sexual harassment, leading to working women. Denmark’s hedonistic culture underlies lifestyle-related chronic medical conditions. Norway’s athletic, outdoor is antidepressant. French, Italian, German regions differ expressions depression.

Язык: Английский

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Beyond Shades of Gray: Depression and the Bipolar Spectrum

Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 48 - 59

Опубликована: Янв. 30, 2025

Abstract Many patients who present with depression have an undiagnosed disorder in the bipolar spectrum. Bipolarity is associated more frequent depressive episodes, increased suicide risk, a higher prevalence of comorbid substance use disorders, and several general medical conditions (e.g., migraine hypothyroidism). Antidepressant treatment without mood stabilization often has poor outcome. Cultural issues complicate diagnosis mixed features mild disorder. Systematic screening rating scales like 32-item Hypomania Checklist, Mood Disorder Questionnaire, Clinically Useful Depression Outcome Scale supplemented questions for Diagnostic Statistical Manual Mental Disorders, fifth edition, facilitate identification bipolarity depressed patients; but utility specific questionnaire items optimal cut points vary by culture gender. Social class life stage matter: Specific manifestations hypomania might be tolerated or even normalized among adolescents members upper class. Biomarkers soon aid identifying patients.

Язык: Английский

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